ABNORMAL PSYCHOLOGY FINAL EXAM, Exams of Abnormal Psychology

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ABNORMAL PSYCHOLOGY FINAL EXAM|||questions and answers with rationales/graded A+/2026 update/100% correct Q1. According to the DSM- 5 - TR, how many symptoms from Criterion A are required for a diagnosis of Major Depressive Disorder (MDD), and what two core symptoms must be present? Answer: Five or more symptoms during the same 2-week period, representing a change from previous functioning. At least one symptom must be either (1) depressed mood or (2) anhedonia (loss of interest or pleasure). > Rationale: The remaining symptoms include significant weight change, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, worthlessness/guilt, diminished concentration, and recurrent thoughts of death or suicide. Q2. What is the primary difference between Bipolar I Disorder and Bipolar II Disorder? Answer:

• Bipolar I Disorder requires at least one manic episode (lasting ≥7 days or requiring hospitalization). Major depressive episodes are common but not required.
• Bipolar II Disorder requires at least one hypomanic episode and at least one major depressive episode. There is no history of a full manic episode. > Rationale: Manic episodes cause marked impairment or psychosis; hypomanic episodes are shorter (≥4 days) and do not cause severe functional impairment.

Q3. What is the “bereavement exclusion” in the DSM- 5 - TR, and how has it changed from DSM-IV-TR? Answer: The DSM-IV-TR excluded a diagnosis of MDD within the first two months after the death of a loved one unless certain severe features were present. The DSM- 5 - TR removed this exclusion entirely. > Rationale: The change acknowledges that major depression can occur in response to bereavement and that the two conditions may co-occur. Clinicians are still advised to differentiate normal grief from clinical depression based on symptoms such as pervasive worthlessness, marked functional impairment, and suicidal ideation. Q4. A client presents with a persistent pattern of unstable interpersonal relationships, unstable self-image, and marked impulsivity (e.g., reckless spending, self-injury). Which personality disorder is most likely? List two additional diagnostic criteria. Answer: Borderline Personality Disorder (BPD). Two additional criteria include: (1) chronic feelings of emptiness, (2) intense, inappropriate anger or difficulty controlling anger, (3) transient, stress-related paranoid ideation or severe dissociative symptoms. > Rationale: BPD is characterized by instability in affect, self-image, and relationships. It is frequently comorbid with mood disorders and substance use. Dialectical Behavior Therapy (DBT) is the first-line treatment. Q5. According to the DSM- 5 - TR, what is the minimum duration of symptoms required for a diagnosis of Generalized Anxiety Disorder (GAD)?

1. Negative alterations in cognition and mood – inability to remember parts of the event, persistent negative beliefs, distorted blame, persistent fear/horror/anger, diminished interest, detachment, inability to experience positive emotions.
2. Alterations in arousal and reactivity – irritable/angry behavior, reckless/self-destructive behavior, hypervigilance, exaggerated startle response, concentration problems, sleep disturbance. > Rationale: DSM- 5 - TR also includes a dissociative subtype (depersonalization/derealization) and a specifier for preschool children. Q8. What is the key diagnostic feature of Obsessive-Compulsive Disorder (OCD) that distinguishes it from everyday worries or superstitions? Answer: The presence of obsessions (recurrent, intrusive, unwanted thoughts, urges, or images that cause marked anxiety) and/or compulsions (repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession). These symptoms are time-consuming (take >1 hour/day) or cause clinically significant distress/impairment, and the person recognizes that they are excessive or unreasonable (insight may be poor in some cases). > Rationale: OCD is now classified separately from anxiety disorders in its own chapter (Obsessive-Compulsive and Related Disorders). Distress and functional impairment are required. Q9. Which disorder is characterized by recurrent episodes of binge eating without compensatory behaviors (e.g., purging, fasting, excessive exercise)? Answer: Binge-Eating Disorder (BED). Binges involve eating a large amount of food in a discrete period with a sense of loss of

control. Episodes occur at least once weekly for 3 months. Unlike bulimia nervosa, compensatory behaviors are absent. > Rationale: BED is the most common eating disorder. Comorbid obesity and depression are common. First-line treatments include CBT and interpersonal therapy; lisdexamfetamine is FDA-approved. Q10. What is the difference between Schizophrenia and Schizoaffective Disorder? Answer:

• Schizophrenia requires two or more core symptoms (delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms) for at least 6 months, including 1 month of active phase symptoms. Mood episodes (major depressive or manic) are not required.
• Schizoaffective Disorder requires an uninterrupted period of illness during which there is a major mood episode (depressive or manic) concurrent with Criterion A of schizophrenia. In addition, delusions or hallucinations must be present for at least 2 weeks in the absence of major mood symptoms. > Rationale: The distinction hinges on whether mood symptoms occur only during active psychotic phases or also independently. Prognosis for schizoaffective disorder is slightly better than schizophrenia but worse than mood disorders alone. Q11. Name three negative symptoms of schizophrenia and provide an example of each. Answer:

1. Avolition – decreased goal-directed activity (e.g., no longer bathing, pays no attention to appearance).

Q13. According to the Research Domain Criteria (RDoC) framework, how does it differ from DSM- 5 - TR in conceptualizing psychopathology? Answer: RDoC is a transdiagnostic, dimensional research framework organized by domains of functioning (e.g., negative valence systems, positive valence systems, cognitive systems, social processes, arousal/regulatory systems). It integrates multiple levels of analysis (genes, neural circuits, behavior, self-report) and is not intended for clinical diagnosis. Difference: DSM- 5 - TR is a categorical, criteria-based classification system for clinical use, whereas RDoC is a research framework aimed at understanding basic mechanisms of psychopathology across traditional diagnostic boundaries. > Rationale: RDoC was developed by NIMH to address DSM’s limitations, including high comorbidity, heterogeneity within categories, and poor translation from basic neuroscience. Q14. A client has a chronic pattern of disregard for and violation of the rights of others since age 15, with evidence of Conduct Disorder before age 15. Which personality disorder is most likely? Answer: Antisocial Personality Disorder (ASPD). Criteria include failure to conform to social norms (repeated arrests), deceitfulness, impulsivity, irritability/aggressiveness, reckless disregard for safety of self or others, consistent irresponsibility, and lack of remorse. > Rationale: ASPD requires age ≥18 and evidence of Conduct Disorder with onset before 15 years. It is more common in males and associated with substance use and lower socioeconomic status. Treatment is notoriously difficult.

Q15. What is the “prodromal phase” of Schizophrenia? Name two early signs that may appear during this phase. Answer: The prodromal phase is the period of declining functioning before the first full psychotic episode. Signs include: (1) social withdrawal or isolation, (2) unusual or odd beliefs/magical thinking, (3) perceptual abnormalities (e.g., feeling watched), (4) marked impairment in school/work performance, (5) decline in hygiene. > Rationale: Early identification and intervention during the prodrome may delay or prevent onset of full psychosis. High-risk (ultra-high risk) clinical criteria have been developed for research and early intervention programs. Q16. What is the difference between “illness anxiety disorder” and “somatic symptom disorder”? Answer:

• Illness Anxiety Disorder – preoccupation with having or acquiring a serious illness, with minimal or no somatic symptoms present. High health anxiety persists despite medical reassurance.
• Somatic Symptom Disorder – one or more distressing somatic symptoms (e.g., pain, fatigue) that are accompanied by disproportionate and persistent thoughts, anxiety, or time/energy devoted to the symptoms. The focus is on the symptom itself, not merely the fear of illness. > Rationale: Both are somatic symptom and related disorders. Illness anxiety disorder may include care-seeking or care-avoidant subtypes. Neither requires symptoms to be medically unexplained. **Q17. A client reports recurrent, intrusive, distressing thoughts that a loved one will be harmed if they do not tap their desk seven times before turning off a light. They feel driven to perform the

> Rationale: Specifiers guide treatment selection (e.g., light therapy for seasonal pattern; lithium augmentation for melancholia). Q19. A client experiences recurrent episodes of sleep paralysis, hypnagogic/hypnopompic hallucinations, and sudden loss of muscle tone triggered by laughter or anger. Which disorder is most likely? What is the underlying neurotransmitter abnormality? Answer: Narcolepsy Type 1 (narcolepsy with cataplexy). The underlying abnormality is loss of hypocretin (orexin) neurons in the lateral hypothalamus, leading to inability to regulate sleep-wake boundaries. > Rationale: Cataplexy (muscle weakness triggered by emotion) is pathognomonic for Type 1. Treatment includes stimulants for daytime sleepiness and REM-suppressing agents (e.g., sodium oxybate) for cataplexy. Q20. What is the difference between “dissociative amnesia” and “dissociative fugue” in DSM- 5 - TR? Answer:

• Dissociative amnesia – inability to recall important autobiographical information (usually traumatic or stressful), not explained by ordinary forgetfulness. It may be localized (cannot recall events from a specific period) or selective (cannot recall some details from a period).
• Dissociative fugue – in DSM- 5 - TR, fugue is not a separate disorder but a specifier of dissociative amnesia (“dissociative amnesia with dissociative fugue”). It involves purposeful travel or bewildered wandering, often with loss of identity or formation of a new identity.

> Rationale: The change simplifies classification. Fugue specifier applies when the amnesia includes sudden, unexpected travel. Q21. Describe the “symptom overlap” between Attention-Deficit/Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD). How can a clinician differentiate them? Answer: Overlapping symptoms include restlessness, difficulty concentrating, irritability, and sleep disturbance. Differential diagnosis:

• ADHD – onset in childhood (by age 12), lifelong persistence, core deficits in sustained attention, impulsivity, and hyperactivity not driven by worry. Symptoms are present across multiple settings and are not better explained by anxiety.
• GAD – excessive worry about multiple domains is central; concentration problems arise from rumination. Restlessness is due to tension, not hyperactivity. Onset often later, though childhood GAD occurs. Clinicians can assess worry content, developmental history, and response to anxiolytic vs. stimulant trial. > Rationale: Comorbidity is common (~30% of adults with ADHD have GAD). Validated scales and family history help differentiate. Q22. What is the “positive symptom” and “negative symptom” distinction in schizophrenia? Give two examples of each. Answer:
• Positive symptoms – excess or distortion of normal functions. Examples: delusions (fixed false beliefs), hallucinations (sensory perceptions without external stimulus).